Can We Help Opioid Abusers Without Jailing Them?

As the nation continue to suffer from the opioid epidemic, programs that can divert substance abusers away from the criminal justice system are critical. One increasingly popular approach called “deflection” partners police and public health workers.

Out of the tremendous heartbreak and suffering of our nation’s opioid epidemic, something new and hopeful is happening in communities across the country.

Police officers and drug treatment providers, previously unaccustomed and sometimes even reluctant to partner with one another, now can be found working side by side to reverse overdoses and connect people to drug treatment.

And while these emerging public safety-public health partnerships are not limited to combatting opioids—they also can address drug use in general, housing, mental health, and social services—it is the overwhelming number of people overdosing and dying from opioids that has accelerated the growth of these collaborations, and catalyzed their value in both saving lives and fighting crime.

The new approach is called ‘deflection.”

In deflection, law enforcement plays the critical role of connecting people to community-based treatment partners. This interaction may occur right on the street at the point of encounter, in the police or fire station, at the person’s home, or wherever the initial encounter occurs, all without fear of arrest.

On the receiving end of this “warm hand-off” are treatment providers and/or peer recovery partners who follow through to ensure the individual’s access to services. The operational specifics of each deflection program depend on the design of the local initiative, but the core idea is consistent: Instead of being a doorway into the justice system, law enforcement instead deflects people with substance use disorders to treatment.

Taken together, these new relationships signify the growing importance of “deflection,” which operates squarely at the intersection of law enforcement and treatment.

Sometimes referred to by other terms such as pre-arrest diversion, deflection is growing rapidly from its infancy. A few such programs came about in the 1990s and then faded, but the opioid epidemic has prompted new urgency for these efforts, birthing, or rebirthing, a wide variety of deflection efforts.

The most visible entry to this new stage was Seattle’s Law Enforcement Assisted Diversion (LEAD) program in 2011. Others soon followed, from the 2014 Civil Citation Network in Alachua and Leon County (FL) and the 2014 Drug Abuse Resistance Team (DART) in Lucas County, Ohio; to the 2015 “Angel” and “Arlington Outreach” programs in Massachusetts and the 2015 Quick Response Teams (QRT) developing in communities in Ohio and elsewhere around the country.

Combined with its longer-serving counterparts on the mental health side—such as Crisis Intervention Teams, co-responders, and triage centers—deflection is changing the narrative about fighting crime from “We can’t arrest our way out of this” to “We have better options than arrest.”

Deflection as a term is differentiated from its cousin in the justice system: diversion. In deflection, it is the presence of a behavioral health issue that is driving the contact with police that in turn triggers the deflection (movement) away from the justice system and to community-based behavioral health.

In the vast majority of these cases there are no criminal charges present, responding to the reality that 81 percent of police encounters are, in the final analysis, social service calls. (There are a smaller number of deflection efforts that allow for criminal charges to be placed in abeyance by the police or a citation with mandatory treatment is issued but still in these cases, no traditional justice involvement is required.)

To be sure, some ongoing contact between law enforcement and treatment is helpful beyond that deflection handoff. In some cases, ongoing communication between partners can serve to de-conflict ongoing encounters, share status updates, and support the person who’s been deflected to treatment.

Still, the intent is not meant to add to the already unrealistic expectations placed upon law enforcement to solve chronic social problems, but instead to lighten the burden from where it does not belong – law enforcement – and instead place it with community treatment, housing, healthcare, and social services.

Deflection does increase the demand for treatment capacity and, as such, strategies and action are needed to assure quick and sufficient treatment availability wherever deflection initiatives exist.

In looking at the variety of existing deflection programs, five “pathways” broadly summarize different ways that law enforcement is connecting people to treatment:

  • Self-referral
  • Active Outreach
  • Naloxone Plus
  • Officer Prevention
  • Officer Intervention

Each of these pathways describes the linkage point between police and treatment. While jurisdictions will usually start by facilitating a single pathway, in time as they get experience in deflection and see first-hand the power of their collaborative work, they will begin to add in additional pathways.

Currently, out of 18,000 law enforcement agencies in the United States, it is estimated that slightly over 600 departments are doing some type of deflection.

In the face of a national opioid epidemic, the growth of the field has occurred almost entirely in the last three years. As such, programs continue to be developed and implemented across the county—responding not just to opioids, but to any drug crises that communities face—collectively they can actually reduce the flow of people into the criminal justice system, while also offering necessary referrals to community-based treatment, housing, and services.

Annually, our nation’s 800,000 law enforcement officers encounter 68 million people, some 12 million of whom will end up churning through our jails. Police also encounter millions of people each year for whom there are no criminal charges present, but who have health, housing, and social service needs.

Jac Charlier

Jac A. Charlier

And, given that the majority of people who currently enter the justice system have a substance use disorder, a mental health condition, or both, deflection provides the opportunity to redirect people to treatment before they reach the justice system, emergency rooms, or homeless shelters.

In a country where over 72,000 people died from overdose in 2017 alone, the expansion of these deflection efforts by law enforcement, and the parallel expansion of treatment capacity, cannot happen soon enough.

Jac A. Charlier is executive director of the TASC Center for Health and Justice, and co-founder of the Police, Treatment, and Community Collaborative (PTACC). He welcomes readers’comments. NOTE: Jac is among the speakers scheduled for this year’s John Jay/HF Guggenheim Symposium on Crime in America. Please watch our site for upcoming information on how to register.


Police Deflection: The Screen Door at the Front of the Justice System

Confronted with people clearly in need of treatment and social services, law enforcement officers need a way to respond, because they know they’ll see them again. A new approach gaining traction across the country offers “a public health approach to better public safety.”

Law enforcement officers know the routine well. They encounter someone who has a drug addiction or a mental health problem. Sometimes they stop the person for a low-level offense, such as drug possession, petty theft, or vagrancy.

Sometimes this might mean arrest, but often it means not being able to do anything.

If an arrest is made and the person is prosecuted, then very often, he or she will be arrested again and the cycle continues.

Confronted with people clearly in need of treatment and social services, law enforcement officers need a way to respond, because they know they’ll see them again. Confronted with violations of the law, officers cannot simply ignore what’s happening.

But continually arresting individuals for low-level offenses only exacerbates problems. As officers have said for decades, “we cannot arrest our way out of social problems.”

What if officers had a third option?

Increasingly, in jurisdictions across the country, they do.

They do in Tallahassee, Florida. In Gloucester, Massachusetts. In Lucas County, Ohio; Montgomery County, Maryland; and Seattle, Washington. These are some of the more than 250—and counting—jurisdictions across the United States that are part of rapidly emerging criminal justice efforts that collectively are called “deflection.”

Deflection is a term coined in 2014 to represent a broad range of alternatives that take place as part of law enforcement’s decision-making before an arrest is made. Existing deflection initiatives may include pre-arrest or pre-booking diversion, law enforcement diversion, and police-assisted diversion.

Deflection involves a different approach than prosecutorial or court-based diversion, where a person already faces criminal charges and is subsequently moved out of the system. It is defined as moving a person away from the justice system and toward community behavioral health and social services without ever being arrested and processed into the criminal justice system.

Deflection is a public health approach to better public safety.

Earlier this month, the Center for Health and Justice at the Chicago-based nonprofit called Treatment Alternatives for Safe Communities (TASC) and the Civil Citation Network co-convened the first-ever National Deflection Summit in Alexandria, VA.

The summit brought together 45 leaders representing law enforcement, behavioral health, research, and public policy partners. Among the participants were “brand name” deflection programs, including Adult Civil Citation, the Angel and Arlington models (part of the PAARI network, the largest number of deflection sites in the country), LEAD (Law Enforcement Assisted Diversion), and STEER (Stop, Triage, Engage, Educate, and Rehabilitate).

The summit involved an exchange of experience, insights and thoughts about deflection, including how deflection can be used in confronting the opioid crisis. At the conclusion of the summit, it was decided to move forward together—law enforcement, treatment, researchers and partners—to provide national vision, leadership, voice and action regarding deflection.

Accountability Without Arrest

Drug use and mental health issues are the major drivers of criminal justice involvement.

Deflection identifies and treats these underlying issues as a health issue first, and public safety event only when they present a real risk to others’ well-being. Through this approach, encounters with law enforcement involve screening to determine who may be deflected to services before an arrest is made and without locking people up.

This real-time sorting is done by officers and behavioral health experts based on the person’s own desire to receive help, behavioral triage, or if criminal charges could be brought, it might involve their risk to re-offend and identified treatment needs. If deflected, there are no criminal charges filed and many deflection initiatives do not require criminal charges even be present in the first place.

Early deflection programs show promising results. For those communities that have practiced pre-arrest diversion to treatment for several years, the rearrest rates for those receiving behavioral intervention services have significantly decreased.

Beyond these early initiatives, there is now a sizable expansion of programs that connect law enforcement to community-based treatment, and that paradigm shift can transform the front door of the justice system. When deflection is scaled using universal screening, referral, and intervention/treatment, the numbers of individuals entering the justice system should drop —assuming the availability of sufficient behavioral health services in the community.

Through expanded use of deflection, law enforcement could become the largest referral source to behavioral health and social services in U.S. criminal justice history.

Deflection makes every law enforcement officer a potential pathway to behavioral intervention services, drug treatment, mental health treatment, and social services when called for. Based on the street-level experiences of police officers who see the same drug users and people with mental illness daily on their beats, and know an arrest will do absolutely nothing to solve the situation, deflection adds to the justice system something new.

A screen door.

By reshaping the American criminal justice system so that it holds only those deemed a danger to society, we will achieve a system that is more nimble, agile, and able to focus on addressing offenses that present a real risk to public safety.

This new type of American justice will be able to systematically focus its full attention, resources and efforts on a smaller number of the most dangerous criminals, most urgent public safety challenges, and most intransigent crime issues, while also providing more support for victims of crime.

Perhaps one of the most timely, though not initially obvious, outcomes is improved police/community relations.

Surveys of officers often show that one of the reasons they joined the profession was to help people. Deflection gives law enforcement departments the opportunity to provide and train officers to use an effective alternative to arrest that has a positive outcome.

And the community will see law enforcement repeatedly doing much more than arresting, by truly understanding what residents and their loved ones may need: A place to stay, treatment, or a real shot at a job.

Jac Charlier,  a national expert on police deflection and criminal justice systems-change initiatives, is National Director for Justice Initiatives at the Center for Health and Justice at TASC. He welcomes comments from readers.